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de Andrade Rodrigues RS, Heise EFJ, Hartmann LF, Rocha GE, Olandoski M, de Araújo Stefani MM, Latini ACP, Soares CT, Belone A, Rosa PS, de Andrade Pontes MA, de Sá Gonçalves H, Cruz R, Penna MLF, Carvalho DR, Fava VM, Bührer-Sékula S, Penna GO, Moro CMC, Nievola JC, Mira MT. Prediction of the occurrence of leprosy reactions based on Bayesian networks. Front Med (Lausanne) 2023; 10:1233220. [PMID: 37564037 PMCID: PMC10411956 DOI: 10.3389/fmed.2023.1233220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Leprosy reactions (LR) are severe episodes of intense activation of the host inflammatory response of uncertain etiology, today the leading cause of permanent nerve damage in leprosy patients. Several genetic and non-genetic risk factors for LR have been described; however, there are limited attempts to combine this information to estimate the risk of a leprosy patient developing LR. Here we present an artificial intelligence (AI)-based system that can assess LR risk using clinical, demographic, and genetic data. Methods The study includes four datasets from different regions of Brazil, totalizing 1,450 leprosy patients followed prospectively for at least 2 years to assess the occurrence of LR. Data mining using WEKA software was performed following a two-step protocol to select the variables included in the AI system, based on Bayesian Networks, and developed using the NETICA software. Results Analysis of the complete database resulted in a system able to estimate LR risk with 82.7% accuracy, 79.3% sensitivity, and 86.2% specificity. When using only databases for which host genetic information associated with LR was included, the performance increased to 87.7% accuracy, 85.7% sensitivity, and 89.4% specificity. Conclusion We produced an easy-to-use, online, free-access system that identifies leprosy patients at risk of developing LR. Risk assessment of LR for individual patients may detect candidates for close monitoring, with a potentially positive impact on the prevention of permanent disabilities, the quality of life of the patients, and upon leprosy control programs.
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Affiliation(s)
- Rafael Saraiva de Andrade Rodrigues
- School of Medicine and Life Sciences, Graduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná – PUCPR, Curitiba, Paraná, Brazil
| | - Eduardo Ferreira José Heise
- School of Medicine and Life Sciences, Graduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná – PUCPR, Curitiba, Paraná, Brazil
| | | | | | - Marcia Olandoski
- School of Medicine and Life Sciences, Graduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná – PUCPR, Curitiba, Paraná, Brazil
| | | | | | | | - Andrea Belone
- Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
| | | | | | | | - Rossilene Cruz
- Tropical Dermatology and Venerology Alfredo da Matta Foundation, Amazonas, Brazil
| | | | | | - Vinicius Medeiros Fava
- Program in Infectious Diseases and Immunity in Global Health, Research Institute of the McGill University Health Centre, and The McGill International TB Centre, Departments of Human Genetics and Medicine, McGill University, Montreal, QC, Canada
| | - Samira Bührer-Sékula
- Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiania, Brazil
| | - Gerson Oliveira Penna
- Tropical Medicine Centre, University of Brasília, and Fiocruz School of Government – Brasilia, Brasília, Brazil
| | | | | | - Marcelo Távora Mira
- School of Medicine and Life Sciences, Graduate Program in Health Sciences, Pontifícia Universidade Católica do Paraná – PUCPR, Curitiba, Paraná, Brazil
- Pharmacy Program, School of Health and Biosciences, PUCPR, Curitiba, Paraná, Brazil
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Voltan G, Marques-Júnior W, Santana JM, Lincoln Silva CM, Leite MN, De Paula NA, Bernardes Filho F, Barreto JG, Da Silva MB, Conde G, Salgado CG, Frade MAC. Silent peripheral neuropathy determined by high-resolution ultrasound among contacts of patients with Hansen's disease. Front Med (Lausanne) 2023; 9:1059448. [PMID: 36733931 PMCID: PMC9887334 DOI: 10.3389/fmed.2022.1059448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/21/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Hansen's disease (HD) primarily infects peripheral nerves, with patients without HD being free of peripheral nerve damage. Household contacts (HHCs) of patients with HD are at a 5-10 times higher risk of HD than the general population. Neural thickening is one of the three cardinal signs that define a case of HD according to WHO guidelines, exclusively considering palpation examination that is subjective and may not detect the condition in the earliest cases even when performed by well-trained professionals. High-resolution ultrasound (HRUS) can evaluate most peripheral nerves, a validated technique with good reproducibility allowing detailed and accurate examination. Objective This study aimed to use the peripheral nerve HRUS test according to the HD protocol as a diagnostic method for neuropathy comparing HHCs with healthy volunteers (HVs) and patients with HD. Methods In municipalities from 14 different areas of Brazil we selected at random 83 HHC of MB-patients to be submitted to peripheral nerve ultrasound and compared to 49 HVs and 176 HD-patients. Results Household contacts assessed by HRUS showed higher median and mean absolute peripheral nerve cross-sectional area (CSA) values and greater asymmetries (ΔCSA) compared to HVs at the same points. Median and mean absolute peripheral nerve CSA values were higher in patients with HD compared to HCCs at almost all points, while ΔCSA values were equal at all points. Mean ± SD focality (ΔTpT) values for HHCs and patients with HD, respectively, were 2.7 ± 2.2/2.6 ± 2.2 for the median nerve, 2.9 ± 2.7/3.3 ± 2.9 for the common fibular nerve (p > 0.05), and 1.3 ± 1.3/2.2 ± 3.9 for the ulnar nerve (p < 0.0001). Discussion Considering HRUS findings for HHCs, asymmetric multiple mononeuropathy signs (thickening or asymmetry) in at least 20% of the nerves evaluated could already indicates evidence of HD neuropathy. Thus, if more nerve points are assessed in HHCs (14 instead of 10), the contacts become more like patients with HD according to nerve thickening determined by HRUS, which should be a cutting-edge tool for an early diagnosis of leprosy cases.
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Affiliation(s)
- Glauber Voltan
- Healing and Hansen's Disease Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Wilson Marques-Júnior
- Division of Neuromuscular Disorders, Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jaci Maria Santana
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Claudia Maria Lincoln Silva
- Healing and Hansen's Disease Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marcel Nani Leite
- Healing and Hansen's Disease Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Natália Aparecida De Paula
- Healing and Hansen's Disease Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fred Bernardes Filho
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Josafá Gonçalves Barreto
- Dermato-Immunology Laboratory, Institute of Biological Sciences, Federal University of Pará, Marituba, Brazil
| | - Moises Batista Da Silva
- Dermato-Immunology Laboratory, Institute of Biological Sciences, Federal University of Pará, Marituba, Brazil
| | - Guilherme Conde
- Decision Support Laboratory, Federal University of Pará West, Santarem, Brazil
| | - Claudio Guedes Salgado
- Dermato-Immunology Laboratory, Institute of Biological Sciences, Federal University of Pará, Marituba, Brazil
| | - Marco Andrey Cipriani Frade
- Healing and Hansen's Disease Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- National Referral Center for Sanitary Dermatology and Hansen's Disease, Dermatology Division, Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Cunha EHM, Marçal PHF, Gama RS, de Oliveira LBP, Pinheiro RO, Sarno EN, Brito-de-Sousa JP, de Souza MLM, Fairley JK, Valente TNS, Velloso-Rodrigues C, Martins-Filho OA, de Oliveira DR, Fraga LADO. Interplay among differential exposure to Mycobacterium leprae and TLR4 polymorphism impacts the immune response in household contacts of leprosy patients. Front Immunol 2023; 14:1130137. [PMID: 37187734 PMCID: PMC10175789 DOI: 10.3389/fimmu.2023.1130137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/20/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction The aim of the present study was to investigate the association between the single nucleotide polymorphism (SNP) rs1927914 A/G in TLR4 gene and the immunological profile of household contacts (HHC) of leprosy patients. Leprosy classification is usually complex and requires the assessment of several clinical and laboratorial features. Methods Herein, we have applied distinct models of descriptive analysis to explore qualitative/quantitative changes in chemokine and cytokine production in HHC further categorized according to operational classification [HHC(PB) and HHC(MB)] and according to TLR4SNP. Results and discussion Our results showed that M. leprae stimuli induced an outstanding production of chemokines (CXCL8;CCL2; CXCL9; CXCL10) by HHC(PB), while increase levels of pro-inflammatory cytokines (IL-6; TNF; IFN-γ; IL-17) were observed for HHC(MB). Moreover, the analysis of chemokine and cytokine signatures demonstrated that A allele was associated with a prominent soluble mediator secretion (CXCL8; CXCL9; IL-6; TNF; IFN-γ). Data analysis according to TLR4 SNP genotypes further demonstrated that AA and AG were associated with a more prominent secretion of soluble mediators as compared to GG, supporting the clustering of AA and AG genotypes into dominant genetic model. CXCL8, IL-6, TNF and IL-17 displayed distinct profiles in HHC(PB) vs HHC(MB) or AA+AG vs GG genotype. In general, chemokine/cytokine networks analysis showed an overall profile of AA+GA-selective (CXCL9-CXCL10) and GG-selective (CXCL10-IL-6) axis regardless of the operational classification. However, mirrored inverted CCL2-IL-10 axis and a (IFN-γ-IL-2)-selective axis were identified in HHC(MB). CXCL8 presented outstanding performance to classify AA+AG from GG genotypes and HHC(PB) from HHC(MB). TNF and IL-17 presented elevated accuracy to classify AA+AG from GG genotypes and HHC(PB) (low levels) from HHC(MB) (high levels), respectively. Our results highlighted that both factors: i) differential exposure to M. leprae and ii) TLR4 rs1927914 genetic background impact the immune response of HHC. Our main results reinforce the relevance of integrated studies of immunological and genetic biomarkers that may have implications to improve the classification and monitoring of HHC in future studies.
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Affiliation(s)
- Eloisa Helena Medeiros Cunha
- Universidade Federal de Juiz de Fora, Governador Valadares, MG, Brazil
- Universidade Vale do Rio Doce – Univale, Department of Health Sciences, Governador Valadares, MG, Brazil
| | - Pedro Henrique Ferreira Marçal
- Universidade Federal de Juiz de Fora, Governador Valadares, MG, Brazil
- Universidade Vale do Rio Doce – Univale, Department of Health Sciences, Governador Valadares, MG, Brazil
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
- *Correspondence: Lucia Alves de Oliveira Fraga, ; ; Pedro Henrique Ferreira Marçal, ;
| | - Rafael Silva Gama
- Universidade Vale do Rio Doce – Univale, Department of Health Sciences, Governador Valadares, MG, Brazil
| | | | - Roberta Olmo Pinheiro
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz –FIOCRUZ-RJ, Rio de Janeiro, RJ, Brazil
| | - Euzenir Nunes Sarno
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz –FIOCRUZ-RJ, Rio de Janeiro, RJ, Brazil
| | | | | | - Jessica Kathleen Fairley
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | | | | | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | | | - Lucia Alves de Oliveira Fraga
- Universidade Federal de Juiz de Fora, Governador Valadares, MG, Brazil
- *Correspondence: Lucia Alves de Oliveira Fraga, ; ; Pedro Henrique Ferreira Marçal, ;
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Germano GV, Braga AF, Camargo RMD, Ballalai PB, Bezerra OC, Manta FSDN, Belone ADFF, Soares CT, Das PK, Moraes MO, Latini ACP, Brito de Souza VN. Association of CD209 (DC-SIGN) rs735240 SNV with paucibacillary leprosy in the Brazilian population and its functional effects. Mem Inst Oswaldo Cruz 2022; 117:e220014. [PMID: 35703715 PMCID: PMC9190517 DOI: 10.1590/0074-02760220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leprosy, caused by Mycobacterium leprae, is a public health problem in Brazil that affects peripheral nerves, resulting in physical disabilities. During host-pathogen interactions, the immune response determines leprosy outcomes from a localised (paucibacillary) form to a disseminated (multibacillary) form. The recognition of M. leprae involves the DC-SIGN receptor, which is present on the dendritic cells (DCs) and participates in immune activation. OBJECTIVES To evaluate the association of polymorphisms in the promoter region of the gene encoding DC-SIGN (CD209) and the clinical form of leprosy, and to investigate its functional effects. METHODS The study population included 406 leprosy patients from an endemic area in Brazil [310 multibacillary (MB); 96 paucibacillary (PB)]. A functional evaluation based on the effects of the single nucleotide variant (SNV) associated with PB leprosy on the specific immune response was also performed. RESULTS The GA genotype and the presence of the A allele of rs735240 (-939G>A) were associated with PB leprosy [OR: 2.09 (1.18-3.69) and 1.84 (1.07-3.14), respectively]. Carriers of the A allele showed reduced expression of CD209 and TGF-β1 in leprosy lesions in comparison with individuals with GG genotype, in addition to a higher response to the Mitsuda test. CONCLUSION These data suggest that rs735240 influences the immune response against M. leprae and clinical presentation of leprosy.
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Affiliation(s)
- Giovanna Valle Germano
- Faculdade de Medicina de Botucatu, Programa de Pós-Graduação em Doenças Tropicais, Botucatu, SP, Brasil.,Secretaria de Estado da Saúde de São Paulo, Instituto Lauro de Souza Lima, Bauru, SP, Brasil
| | - André Flores Braga
- Faculdade de Medicina de Botucatu, Programa de Pós-Graduação em Doenças Tropicais, Botucatu, SP, Brasil.,Secretaria de Estado da Saúde de São Paulo, Instituto Lauro de Souza Lima, Bauru, SP, Brasil
| | - Rodrigo Mendes de Camargo
- Faculdade de Medicina de Botucatu, Programa de Pós-Graduação em Doenças Tropicais, Botucatu, SP, Brasil.,Secretaria de Estado da Saúde de São Paulo, Instituto Lauro de Souza Lima, Bauru, SP, Brasil
| | | | - Ohanna Cavalcanti Bezerra
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Hanseníase, Rio de Janeiro, RJ, Brasil
| | | | | | | | - Pranab Kumar Das
- University of Birmingham, College of Medical and Dental Sciences, Division of Infection and Immunity, Department of Clinical Immunology, Edgbaston, UK
| | - Milton Ozório Moraes
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Hanseníase, Rio de Janeiro, RJ, Brasil
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Habiburrahman M, Ariq H, Yusharyahya SN. The Role of Lipid and the Benefit of Statin in Augmenting Rifampicin Effectivity for a Better Leprosy Treatment. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Although leprosy remains as a serious disease of the skin and nervous system, the current treatment is still lacking in its effectiveness. This literature review will explore the association of lipid and leprosy, as well as the potential of statin and other lipid-lowering agents as adjunctive drugs to combat leprosy. Articles were searched through the PubMed, EBSCOhost, and Google Scholar with the keywords: immunomodulation, lipid-body, lipids, leprosy, Mycobacterium leprae, pathogenesis, rifampin or rifampicin, and statins. A manual searching is also carried out to find an additional relevant information to make this literature review more comprehensive. The literatures showed that lipids are highly correlated with leprosy through alterations in serum lipid profile, metabolism, pathogenesis, and producing oxidative stress. Statins can diminish lipid utilization in the pathogenesis of leprosy and show a mycobactericidal effect by increasing the effectiveness of rifampicin and recover the function of macrophages. In addition, Statins have anti-inflammatory properties which may aid in preventing type I and II reactions in leprosy. Standard multidrug therapy might reduce the efficacy of statins, but the effect is not clinically significant. The statin dose-response curve also allows therapeutic response to be achieved with minimal dose. The various pleiotropic effects of statins make it a potential adjunct to standard treatment for leprosy in the future.
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Niitsuma ENA, Bueno IDC, Arantes EO, Carvalho APM, Xavier Junior GF, Fernandes GDR, Lana FCF. Factors associated with the development of leprosy in contacts: a systematic review and meta-analysis. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210039. [PMID: 34231829 DOI: 10.1590/1980-549720210039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/20/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To investigate the risk factors associated with leprosy in contacts of patients. METHOD We carried out a systematic review and meta-analysis by searching the databases MEDLINE, Embase, Cochrane Library, CINAHL, LILACS, Scopus, and Web of Science until September 2019. Four reviewers carried out the selection, analysis, and evaluation of quality of studies. The random effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (95% CI) when heterogeneity was greater than 50%. RESULTS The search resulted in 2,148 references and included 24 reports. Most of the studies had been conducted in Brazil and India, had a cohort design and included household, neighbors, and social contacts. The risk factors associated with illness due to leprosy in contacts were: illiteracy (RR = 1,48; 95%CI 1,22 - 1,79), living in the same house (RR = 2,41; 95%CI 1,87 - 3,10) of a case of leprosy with high bacillary load (RR = 2.40; 95%CI 1.69 - 3.41), seropositivity to the Mycobacterium leprae PGL-1 (phenolic glycolipid-1) antigen (RR = 3.54; 95%CI 2.21 - 5.67), presence of the bacillus in the bloodstream (RR = 10.61; 95%CI 4.74 - 23.77) and negative Mitsuda reaction (RR = 2,68; 95%CI 1,76 - 4,07). Immunization with BCG (bacillus Calmette-Guérin) vaccine had a protective effect against leprosy. CONCLUSION Leprosy in contacts of patients involves social determination, individual susceptibility, and difficulties in access to disease control actions, but modifiable risk factors are the main determinants of illness in this population.
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Affiliation(s)
- Eyleen Nabyla Alvarenga Niitsuma
- Instituto Federal de Educação, Ciência e Tecnologia do Norte de Minas Gerais - Almenara (MG), Brasil.,Programa de Pós-graduação em Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Isabela de Caux Bueno
- Programa de Pós-graduação em Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Elis Oliveira Arantes
- Programa de Pós-graduação em Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Ana Paula Mendes Carvalho
- Diretoria de Vigilância de Condições Crônicas, Secretaria de Estado de Saúde de Minas Gerais - Belo Horizonte (MG), Brasil
| | | | | | - Francisco Carlos Félix Lana
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
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Tió-Coma M, Kiełbasa SM, van den Eeden SJF, Mei H, Roy JC, Wallinga J, Khatun M, Soren S, Chowdhury AS, Alam K, van Hooij A, Richardus JH, Geluk A. Blood RNA signature RISK4LEP predicts leprosy years before clinical onset. EBioMedicine 2021; 68:103379. [PMID: 34090257 PMCID: PMC8182229 DOI: 10.1016/j.ebiom.2021.103379] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Leprosy, a chronic infectious disease caused by Mycobacterium leprae, is often late- or misdiagnosed leading to irreversible disabilities. Blood transcriptomic biomarkers that prospectively predict those who progress to leprosy (progressors) would allow early diagnosis, better treatment outcomes and facilitate interventions aimed at stopping bacterial transmission. To identify potential risk signatures of leprosy, we collected whole blood of household contacts (HC, n=5,352) of leprosy patients, including individuals who were diagnosed with leprosy 4-61 months after sample collection. METHODS We investigated differential gene expression (DGE) by RNA-Seq between progressors before presence of symptoms (n=40) and HC (n=40), as well as longitudinal DGE within each progressor. A prospective leprosy signature was identified using a machine learning approach (Random Forest) and validated using reverse transcription quantitative PCR (RT-qPCR). FINDINGS Although no significant intra-individual longitudinal variation within leprosy progressors was identified, 1,613 genes were differentially expressed in progressors before diagnosis compared to HC. We identified a 13-gene prospective risk signature with an Area Under the Curve (AUC) of 95.2%. Validation of this RNA-Seq signature in an additional set of progressors (n=43) and HC (n=43) by RT-qPCR, resulted in a final 4-gene signature, designated RISK4LEP (MT-ND2, REX1BD, TPGS1, UBC) (AUC=86.4%). INTERPRETATION This study identifies for the first time a prospective transcriptional risk signature in blood predicting development of leprosy 4 to 61 months before clinical diagnosis. Assessment of this signature in contacts of leprosy patients can function as an adjunct diagnostic tool to target implementation of interventions to restrain leprosy development. FUNDING This study was supported by R2STOP Research grant, the Order of Malta-Grants-for-Leprosy-Research, the Q.M. Gastmann-Wichers Foundation and the Leprosy Research Initiative (LRI) together with the Turing Foundation (ILEP# 702.02.73 and # 703.15.07).
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Affiliation(s)
- Maria Tió-Coma
- Department of Infectious Diseases and Leiden University Medical Center, Leiden, The Netherlands
| | - Szymon M Kiełbasa
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Susan J F van den Eeden
- Department of Infectious Diseases and Leiden University Medical Center, Leiden, The Netherlands
| | - Hailiang Mei
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Johan Chandra Roy
- Rural Health Program, The Leprosy Mission International Bangladesh, Nilphamari, Bangladesh
| | - Jacco Wallinga
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Marufa Khatun
- Rural Health Program, The Leprosy Mission International Bangladesh, Nilphamari, Bangladesh
| | - Sontosh Soren
- Rural Health Program, The Leprosy Mission International Bangladesh, Nilphamari, Bangladesh
| | - Abu Sufian Chowdhury
- Rural Health Program, The Leprosy Mission International Bangladesh, Nilphamari, Bangladesh
| | - Khorshed Alam
- Rural Health Program, The Leprosy Mission International Bangladesh, Nilphamari, Bangladesh
| | - Anouk van Hooij
- Department of Infectious Diseases and Leiden University Medical Center, Leiden, The Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annemieke Geluk
- Department of Infectious Diseases and Leiden University Medical Center, Leiden, The Netherlands.
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8
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da Silva MB, Li W, Bouth RC, Gobbo AR, Messias ACC, Moraes TMP, Jorge EVO, Barreto JG, Filho FB, Conde GAB, Frade MAC, Salgado CG, Spencer JS. Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. PLoS One 2021; 16:e0251631. [PMID: 33984058 PMCID: PMC8118453 DOI: 10.1371/journal.pone.0251631] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 04/30/2021] [Indexed: 11/20/2022] Open
Abstract
The number of new cases of leprosy reported worldwide has remained essentially unchanged for the last decade despite continued global use of free multidrug therapy (MDT) provided to any diagnosed leprosy patient. In order to more effectively interrupt the chain of transmission, new strategies will be required to detect those with latent disease who contribute to furthering transmission. To improve the ability to diagnose leprosy earlier in asymptomatic infected individuals, we examined the combined use of two well-known biomarkers of M. leprae infection, namely the presence of M. leprae DNA by PCR from earlobe slit skin smears (SSS) and positive antibody titers to the M. leprae-specific antigen, Phenolic Glycolipid I (anti-PGL-I) from leprosy patients and household contacts living in seven hyperendemic cities in the northern state of Pará, Brazilian Amazon. Combining both tests increased sensitivity, specificity and accuracy over either test alone. A total of 466 individuals were evaluated, including 87 newly diagnosed leprosy patients, 52 post-treated patients, 296 household contacts and 31 healthy endemic controls. The highest frequency of double positives (PGL-I+/RLEP+) were detected in the new case group (40/87, 46%) with lower numbers for treated (12/52, 23.1%), household contacts (46/296, 15.5%) and healthy endemic controls (0/31, 0%). The frequencies in these groups were reversed for double negatives (PGL-I-/RLEP-) for new cases (6/87, 6.9%), treated leprosy cases (15/52, 28.8%) and the highest in household contacts (108/296, 36.5%) and healthy endemic controls (24/31, 77.4%). The data strongly suggest that household contacts that are double positive have latent disease, are likely contributing to shedding and transmission of disease to their close contacts and are at the highest risk of progressing to clinical disease. Proposed strategies to reduce leprosy transmission in highly endemic areas may include chemoprophylactic treatment of this group of individuals to stop the spread of bacilli to eventually lower new case detection rates in these areas.
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Affiliation(s)
- Moises Batista da Silva
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
| | - Wei Li
- Colorado State University, Department of Microbiology, Immunology and Pathology, Mycobacteria Research Laboratories, Fort Collins, CO, Unites States of America
| | - Raquel Carvalho Bouth
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
| | - Angélica Rita Gobbo
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
| | - Ana Caroline Cunha Messias
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
| | - Tania Mara Pires Moraes
- Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará (UFOPA), Santarém, Pará, Brazil
| | - Erika Vanessa Oliveira Jorge
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
| | - Josafá Gonçalves Barreto
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
- Spatial Epidemiology Laboratory, Universidade Federal do Pará—Campus Castanhal, Castanhal, Pará, Brazil
| | - Fred Bernardes Filho
- Division of Dermatology, Department of Internal Medicine of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Marco Andrey Cipriani Frade
- Division of Dermatology, Department of Internal Medicine of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Claudio Guedes Salgado
- Laboratório de Dermato-Imunologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belem, Pará, Brazil
| | - John Stewart Spencer
- Colorado State University, Department of Microbiology, Immunology and Pathology, Mycobacteria Research Laboratories, Fort Collins, CO, Unites States of America
- * E-mail:
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Polymorphisms in mitochondrial ribosomal protein S5 (MRPS5) are associated with leprosy risk in Chinese. PLoS Negl Trop Dis 2020; 14:e0008883. [PMID: 33362202 PMCID: PMC7757804 DOI: 10.1371/journal.pntd.0008883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 10/13/2020] [Indexed: 01/15/2023] Open
Abstract
Leprosy is an infectious disease caused by Mycobacterium leprae (M. leprae), with about 210,000 new cases per year worldwide. Although numerous risk loci have been uncovered by genome-wide association studies, the effects of common genetic variants are relatively modest. To identify possible new genetic locus involved in susceptibility to leprosy, whole exome sequencing was performed for 28 subjects including 14 patients and 12 unaffected members from 8 leprosy-affected families as well as another case and an unrelated control, and then the follow-up SNP genotyping of the candidate variants was studied in case-control sample sets. A rare missense variant in mitochondrial ribosomal protein S5 (MRPS5), rs200730619 (c. 95108402T>C [p. Tyr137Cys]) was identified and validated in 369 cases and 270 controls of Chinese descent (Padjusted = 0.006, odds ratio [OR] = 2.74) as a contributing factor to leprosy risk. Moreover, the mRNA level of MRPS5 was downregulated in M. leprae sonicate-stimulated peripheral blood mononuclear cells. Our results indicated that MRPS5 may be involved in leprosy pathogenesis. Further studies are needed to determine if defective MRPS5 could lead to impairment of energy metabolism of host immune cells, which could further cause defect in clearing M. leprae and increase susceptibility to infection.
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Marçal PHF, Gama RS, Pereira de Oliveira LB, Martins-Filho OA, Pinheiro RO, Sarno EN, Moraes MO, de Oliveira Fraga LA. Functional biomarker signatures of circulating T-cells and its association with distinct clinical status of leprosy patients and their respective household contacts. Infect Dis Poverty 2020; 9:167. [PMID: 33341111 PMCID: PMC7749990 DOI: 10.1186/s40249-020-00763-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Leprosy is a chronic infectious disease classified into two subgroups for therapeutic purposes: paucibacillary (PB) and multibacillary (MB), closely related to the host immune responses. In this context it is noteworthy looking for immunological biomarkers applicable as complementary diagnostic tools as well as a laboratorial strategy to follow-up leprosy household contacts. METHODS The cross-sectional study enrolled 49 participants, including 19 patients and 30 healthy controls. Peripheral blood mononuclear cells (PBMC) were isolated and incubated in the presence of Mycobacterium leprae bacilli. The cells were prepared for surface (CD4+ and CD8+) and intracytoplasmic cytokine staining (IFN-γ, IL-4 and IL-10). Multiple comparisons amongst groups were carried out by ANOVA, Kruskal-Wallis, Student T or Mann-Whitney test. Comparative analysis of categorical variables was performed by Chi-square. Functional biomarker signature analysis was conducted using the global median values for each biomarker index as the cut-off edge to identify the proportion of subjects with high biomarker levels. RESULTS The cytokine signature analysis demonstrated that leprosy patients presented a polyfunctional profile of T-cells subsets, with increased frequency of IFN-γ+ T-cell subsets along with IL-10+ and IL-4+ from CD4+ T-cells, as compared to health Controls (Venn diagram report). Moreover, statistical analysis was carried out using parametric or non-parametric variance analysis followed by pairwise multiple comparisons, according to the data normality distribution. L(PB) displayed a polyfunctional profile characterized by enhanced percentage of IFN-γ+, IL-10+ and IL-4+ produced by most T-cell subsets, as compared to L(MB) that presented a more restricted cytokine functional profile mediated by IL-10+ and IL-4+ T-cells with minor contribution of IFN-γ produced by CD4+ T-cells. Noteworthy was that HHC(MB) exhibited enhanced frequency of IFN-γ+ T-cells, contrasting with HHC(PB) that presented a cytokine profile limited to IL-10 and IL-4. CONCLUSIONS Our data demonstrated that L(PB) displayed enhanced percentage of IFN-γ+, IL-10+ and IL-4+ as compared to L(MB) that presented functional profile mediated by IL-10+ and IL-4+ T-cells and HHC(MB) exhibited enhanced frequency of IFN-γ+ T-cells, contrasting with HHC(PB). Together, our findings provide additional immunological features associated with leprosy and household contacts. These data provide evidence that biomarkers of immune response can be useful complementary diagnostic/prognostic tools as well as insights that household contacts should be monitored to access putative subclinical infection.
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Affiliation(s)
| | - Rafael Silva Gama
- Universidade Vale do Rio Doce - Univale, Governador Valadares, MG, Brazil
| | | | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, FIOCRUZ-Minas, Belo Horizonte, MG, Brazil
| | - Roberta Olmo Pinheiro
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz -FIOCRUZ-RJ, Rio de Janeiro, RJ, Brazil
| | - Euzenir Nunes Sarno
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz -FIOCRUZ-RJ, Rio de Janeiro, RJ, Brazil
| | - Milton Ozório Moraes
- Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz -FIOCRUZ-RJ, Rio de Janeiro, RJ, Brazil
| | - Lucia Alves de Oliveira Fraga
- Núcleo de Pesquisa em Hansenologia, Universidade Federal de Juiz de Fora, Instituto de Ciências da Vida, Campus Governador Valadares, Rua São Paulo, 582 - Centro, Governador Valadares, MG, 30190-002, Brazil.
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11
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Mendes ALG, Joaquim HDM, Zamae MIS, Assis RM, Peixoto JRDM, de Araújo MMG, Guedes ACM, Oliveira EJ, Magalhães VP, Pascoal-Xavier MA. Expression of NLRP3 inflammasome in leprosy indicates immune evasion of Mycobacterium leprae. Mem Inst Oswaldo Cruz 2020; 115:e190324. [PMID: 32130367 PMCID: PMC7046136 DOI: 10.1590/0074-02760190324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/22/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leprosy is an infectious-contagious disease caused by Mycobacterium
leprae that remain endemic in 105 countries. This neglected
disease has a wide range of clinical and histopathological manifestations
that are related to the host inflammatory and immune responses. More
recently, the inflammasome has assumed a relevant role in the inflammatory
response against microbiological agents. However, the involvement of
inflammasome in leprosy remains poorly understood. OBJECTIVES The aim is to associate biomarkers of inflammasome with the different
immunopathological forms of leprosy. METHODS We performed an observational, cross-sectional, and comparative study of the
immunophenotypic expression of inflammasome-associated proteins in
immunopathological forms of leprosy of 99 skin lesion samples by
immunohistochemistry. The intensity and percentage of NLRP3, Caspase-1,
Caspases-4/5, interleukin-1β and interleukin-18 immunoreactivities in the
inflammatory infiltrate of skin biopsies were evaluated. FINDINGS Strong expression of NLRP3 and inflammatory Caspases-4/5 were observed in
lepromatous leprosy (lepromatous pole). In addition, were observed low
expression of caspase-1, interleukin-1β, and interleukin-18 in tuberculoid
and lepromatous leprosy. The interpolar or borderline form showed
immunophenotype predominantly similar to the lepromatous pole. MAIN CONCLUSIONS Our results demonstrate that the NLRP3 inflammasome is inactive in leprosy,
suggesting immune evasion of M. leprae.
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Affiliation(s)
- Ana Luisa Gomes Mendes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Heloísa Di Matteo Joaquim
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Mara Inês Stefanini Zamae
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Ramon Meira Assis
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Jéssica Renata de Moura Peixoto
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Margarida Maria Gomes de Araújo
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil
| | - Antônio Carlos Martins Guedes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Clínica Médica, Belo Horizonte, MG, Brasil
| | - Edward José Oliveira
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Belo Horizonte, MG, Brasil
| | | | - Marcelo Antônio Pascoal-Xavier
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Anatomia Patológica e Medicina Legal, Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Belo Horizonte, MG, Brasil
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12
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Dwivedi VP, Banerjee A, Das I, Saha A, Dutta M, Bhardwaj B, Biswas S, Chattopadhyay D. Diet and nutrition: An important risk factor in leprosy. Microb Pathog 2019; 137:103714. [PMID: 31493502 DOI: 10.1016/j.micpath.2019.103714] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/09/2019] [Accepted: 09/02/2019] [Indexed: 01/18/2023]
Abstract
Leprosy, once considered as poor man's disease may cause severe neurological complications and physical disabilities. Classification of leprosy depends upon the cell mediated and humoral immune responses of the host, from tuberculoid to lepromatous stage. Current therapy to prevent the disease is not only very lengthy but also consists of expensive multiple antibiotics in combination. Treatment and the duration depend on the bacillary loads, from six months in paucibacillary to a year in multibacillary leprosy. Although as per WHO recommendations, these antibiotics are freely available but still out of reach to patients of many rural areas of the world. In this review, we have focused on the nutritional aspect during the multi-drug therapy of leprosy along with the role of nutrition, particularly malnutrition, on susceptibility of Mycobacterium leprae and development of clinical symptoms. We further discussed the diet plan for the patients and how diet plans can affect the immune responses during the disease.
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Affiliation(s)
- Ved Prakash Dwivedi
- Immunobiology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, 110067, India.
| | - Arindam Banerjee
- Rafi Ahmed Dental College, Govt of West Bengal, Moulalai, Kolkata, 7600014, India
| | - Indraneel Das
- Declibac Technologies Private Limited, 24 B, Lake Road, Kolkata, 700 029, India
| | - Aparajita Saha
- Nutri-Diet Kolkata, 34A Charu Avenue, Kolkata, 700033, India
| | - Malabika Dutta
- Department of Dietetics, Kothari Medical Center, 8/3 Alipore Road, Kolkata, 700027, India
| | - Bhavya Bhardwaj
- Immunobiology Group, International Centre for Genetic Engineering and Biotechnology, Aruna Asaf Ali Marg, New Delhi, 110067, India
| | - Saptarshi Biswas
- Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, 695014, India
| | - Debprasad Chattopadhyay
- ICMR-National Institute of Traditional Medicine, Nehru Nagar, Belagavi, 590010, India; ICMR-Virus Unit, ID & BG Hospital, General Block 4, 57 Dr Suresh C Banerjee Road, Beliaghata, Kolkata, 700010, India.
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Detection of Mycobacterium leprae DNA in soil: multiple needles in the haystack. Sci Rep 2019; 9:3165. [PMID: 30816338 PMCID: PMC6395756 DOI: 10.1038/s41598-019-39746-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/25/2019] [Indexed: 01/09/2023] Open
Abstract
Leprosy is an infectious disease caused by Mycobacterium leprae affecting the skin and nerves. Despite decades of availability of adequate treatment, transmission is unabated and transmission routes are not completely understood. Despite the general assumption that untreated M. leprae infected humans represent the major source of transmission, scarce reports indicate that environmental sources could also play a role as a reservoir. We investigated whether M. leprae DNA is present in soil of regions where leprosy is endemic or areas with possible animal reservoirs (armadillos and red squirrels). Soil samples (n = 73) were collected in Bangladesh, Suriname and the British Isles. Presence of M. leprae DNA was determined by RLEP PCR and genotypes were further identified by Sanger sequencing. M. leprae DNA was identified in 16.0% of soil from houses of leprosy patients (Bangladesh), in 10.7% from armadillos’ holes (Suriname) and in 5% from the habitat of lepromatous red squirrels (British Isles). Genotype 1 was found in Bangladesh whilst in Suriname the genotype was 1 or 2. M. leprae DNA can be detected in soil near human and animal sources, suggesting that environmental sources represent (temporary) reservoirs for M. leprae.
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14
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Escamilla-Tilch M, Pérez-Suárez TG, Torres-Carrillo NM, Rodríguez-Guillén R, Arenas-Guzmán R, Torres-Hernández M, Fafutis-Morris M, Estrada-Parra S, Estrada-Garía I, García-Lechuga M, Granados J, Ramos-Payan R. Analysis of the rs2476601 polymorphism of PTPN22 in Mexican mestizo patients with leprosy. Biomed Rep 2019; 10:127-132. [PMID: 30675352 DOI: 10.3892/br.2019.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 12/18/2018] [Indexed: 11/06/2022] Open
Abstract
Leprosy, a human chronic granulomatous disease caused by Mycobacterium leprae (M. leprae), remains endemic in certain countries despite the use of multidrug therapy. Recently, several host genes modulating the immune responses to M. leprae infection have been suggested to influence the acquisition and clinical course of leprosy. Lymphoid protein tyrosine phosphatase, encoded by the protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene, serves a negative regulatory role in T cell activation. The non-synonymous single-nucleotide polymorphism (SNP) rs2476601 (1858C>T) has been associated with autoimmune diseases. Here, the present study investigated if rs2476601 polymorphism was associated with leprosy in a Mexican mestizo population. Genotyping was performed in patients with leprosy (n=189) and control subjects (n=231) from regions with higher incidence of leprosy. Genotypic (P=0.44) and allelic frequencies (P=0.45) of the rs2476601 polymorphism were similar between patients and controls; genotypic frequencies were 91 vs. 94% for CC and 9 vs. 6% for CT, and the TT genotype was absent in both groups. Allelic frequencies were 96 vs. 97% for C, and 4 vs. 3% for T. In the same way, the genotypic (P=0.46) and allelic frequencies (P=0.47) from MB patients and controls were similar. In conclusion, there was a lack of association of the PTPN22 rs2476601 polymorphism with the development of leprosy, which suggests that this SNP was not a genetic risk factor for leprosy in the Mexican mestizo population studied.
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Affiliation(s)
- Mónica Escamilla-Tilch
- Coordinación de Investigación, Centro Médico Nacional '20 de Noviembre', Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03100
| | - Thalía Gabriela Pérez-Suárez
- Coordinación de Investigación, Centro Médico Nacional '20 de Noviembre', Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03100
| | - Nora Magdalena Torres-Carrillo
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340
| | - Rosario Rodríguez-Guillén
- Unidad de Biología Molecular y Medicina Genómica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000
| | | | - Marcela Torres-Hernández
- Hospital Regional de Psiquiatría, Héctor H. Tovar Acosta, Instituto Mexicano del Seguro Social, Mexico City 14070
| | - Mary Fafutis-Morris
- Centro de Investigación en Inmunología y Dermatología, Instituto Dermatológico de Jalisco, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco 44340
| | - Sergio Estrada-Parra
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340
| | - Iris Estrada-Garía
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City 11340
| | - Maricela García-Lechuga
- Departamento de Trasplantes, División de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000
| | - Julio Granados
- Departamento de Trasplantes, División de Inmunogenética, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14000
| | - Rosalio Ramos-Payan
- Laboratory of Immunology, Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa 80010, México
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15
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Leprosy survey among rural communities and wild armadillos from Amazonas state, Northern Brazil. PLoS One 2019; 14:e0209491. [PMID: 30629624 PMCID: PMC6328080 DOI: 10.1371/journal.pone.0209491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022] Open
Abstract
There is evidence that in southern US, leprosy is a zoonosis infecting wild Dasypus novemcinctus armadillos but the extent of this finding is unknown. This ecological study investigated leprosy in rural communities and in wild armadillos from the Brazilian Amazon. The study area was the Mamiá Lake of Coari municipality, Amazonas State, Northern region, a hyper endemic leprosy area where residents live on subsistence farming, fishing and armadillo hunting and its meat intake are frequent. The leprosy survey was conducted in sixteen communities by a visiting team of specialists. Local partakers provided wild armadillos to investigate M. leprae infection. Volunteers had complete dermato-neurological examination by a dermatologist with expertise in leprosy diagnosis, suspect skin lesions were biopsied for histopathology (Hematoxylin-eosin/HE, Fite-Faraco/FF staining); slit skin smears were collected. Armadillos’ tissue fragments (skins, spleens, livers, lymph nodes, adrenal glands, others) were prepared for histopathology (HE/FF) and for M. leprae repetitive element-RLEP-qPCR. Among 176 volunteers, six new indeterminate leprosy cases were identified (incidence = 3.4%). Suspect skin sections and slit skin smears were negative for bacilli. Twelve wild D. novemcinctus were investigated (48 specimens/96 slides) and histopathological features of M. leprae infection were not found, except for one skin presenting unspecific inflammatory infiltrate suggestive of indeterminate leprosy. Possible traumatic neuroma, granuloma with epithelioid and Langhans cells, foreign-body granuloma were also identified. Granulomatous/non-granulomatous dermatitides were periodic-acid-Schiff/PAS negative for fungus. M. leprae-RLEP-qPCR was negative in all armadillos’ tissues; no bacillus was found in histopathology. Our survey in rural communities confirmed the high endemicity for leprosy while one armadillo was compatible with paucibacillary M. leprae infection. At least in the highly endemic rural area of Coari, in the Brazilian Amazon region where infectious sources from untreated multibacillary leprosy are abundant, M. leprae infected armadillos may not represent a major source of infection nor a significant public health concern.
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Evaluation of Immunodiagnostic Tests for Leprosy in Brazil, China and Ethiopia. Sci Rep 2018; 8:17920. [PMID: 30560920 PMCID: PMC6298962 DOI: 10.1038/s41598-018-36323-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/10/2018] [Indexed: 11/08/2022] Open
Abstract
Leprosy remains persistently endemic in several low- or middle income countries. Transmission is still ongoing as indicated by the unabated rate of leprosy new case detection, illustrating the insufficiency of current prevention methods. Therefore, low-complexity tools suitable for large scale screening efforts to specifically detect M. leprae infection and diagnose disease are required. Previously, we showed that combined detection of cellular and humoral markers, using field-friendly lateral flow assays (LFAs), increased diagnostic potential for detecting leprosy in Bangladesh compared to antibody serology alone. In the current study we assessed the diagnostic performance of similar LFAs in three other geographical settings in Asia, Africa and South-America with different leprosy endemicity. Levels of anti-PGL-I IgM antibody (humoral immunity), IP-10, CCL4 and CRP (cellular immunity) were measured in blood collected from leprosy patients, household contacts and healthy controls from each area. Combined detection of these biomarkers significantly improved the diagnostic potential, particularly for paucibacillary leprosy in all three regions, in line with data obtained in Bangladesh. These data hold promise for the use of low-complexity, multibiomarker LFAs as universal tools for more accurate detection of M. leprae infection and different phenotypes of clinical leprosy.
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de Camargo RM, da Silva WL, Medeiros P, Belone ADFF, Latini ACP. Polymorphisms in the TGFB1 and IL2RA genes are associated with clinical forms of leprosy in Brazilian population. Mem Inst Oswaldo Cruz 2018; 113:e180274. [PMID: 30540075 PMCID: PMC6287188 DOI: 10.1590/0074-02760180274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 11/07/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Leprosy is a chronic infectious disease caused by Mycobacterium leprae, and compromises the skin and peripheral nerves. This disease has been classified as multibacillary (MB) or paucibacillary (PB) depending on the host immune response. Genetic epidemiology studies in leprosy have shown the influence of human genetic components on the disease outcomes. OBJECTIVES We conducted an association study for IL2RA and TGFB1 genes with clinical forms of leprosy based on two case-control samples. These genes encode important molecules for the immunosuppressive activity of Treg cells and present differential expressions according to the clinical forms of leprosy. Furthermore, IL2RA is a positional candidate gene because it is located near the 10p13 chromosome region, presenting a linkage peak for PB leprosy. METHODS A total of 885 leprosy cases were included in the study; 406 cases from Rondonópolis County (start population), a hyperendemic region for leprosy in Brazil, and 479 cases from São Paulo state (replication population), which has lower epidemiological indexes for the disease. We tested 11 polymorphisms in the IL2RA gene and the missense variant rs1800470 in the TGFB1 gene. FINDINGS The AA genotype of rs2386841 in IL2RA was associated with the PB form in the start population. The AA genotype of rs1800470 in TGFB1 was associated with the MB form in the start population, and this association was confirmed for the replication population. MAIN CONCLUSIONS We demonstrated, for the first time, an association data with the PB form for a gene located on chromosome 10. In addition, we reported the association of TGFB1 gene with the MB form. Our results place these genes as candidates for validation and replication studies in leprosy polarisation.
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Affiliation(s)
- Rodrigo Mendes de Camargo
- Instituto Lauro de Souza Lima, Bauru, SP, Brasil
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
| | - Weber Laurentino da Silva
- Instituto Lauro de Souza Lima, Bauru, SP, Brasil
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
| | - Priscila Medeiros
- Instituto Lauro de Souza Lima, Bauru, SP, Brasil
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
| | | | - Ana Carla Pereira Latini
- Instituto Lauro de Souza Lima, Bauru, SP, Brasil
- Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, Departamento de Doenças Tropicais e Diagnóstico por Imagem, Botucatu, SP, Brasil
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Alvarenga Niitsuma EN, Fernandes GDR, Lana FCF. The TLR1 gene is associated with higher protection from leprosy in women. PLoS One 2018; 13:e0205234. [PMID: 30289892 PMCID: PMC6173409 DOI: 10.1371/journal.pone.0205234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 09/21/2018] [Indexed: 01/19/2023] Open
Abstract
Leprosy is an infectious disease with a complex genetic and immunological background. Polymorphisms in genes that encode cytokines and receptors involved in the immune response, such as the Toll-like receptor 1 (TLR1), may be associated with disease risk. We hypothesized that polymorphisms in innate immunity genes confer susceptibility to leprosy that differs between women and men. In this study, we investigate sex differences in the association between a single nucleotide polymorphism (SNP) in TLR1 and Nucleotide-binding oligomerization domain containing 2 (NOD2) genes and leprosy susceptibility in 256 clinically classified leprosy patients and 233 control subjects in a Brazilian population. Our results showed no association between the SNP rs8057341 in NOD2 and leprosy in this population. However, the heterozygous genotype of the TLR1 SNP (rs4833095) showed a statistically significant association in women (OR = 0.54, P = 0.02). Our findings suggest that the TLR1 polymorphism was associated with an increased protection from leprosy in women.
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Affiliation(s)
| | | | - Francisco Carlos Félix Lana
- Department of Maternal and Child Nursing and Public Health, Escola de Enfermagem, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, Minas Gerais, Brasil
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Sharma R, Singh P, Pena M, Subramanian R, Chouljenko V, Kim J, Kim N, Caskey J, Baudena MA, Adams LB, Truman RW. Differential growth of Mycobacterium leprae strains (SNP genotypes) in armadillos. INFECTION GENETICS AND EVOLUTION 2018; 62:20-26. [DOI: 10.1016/j.meegid.2018.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/06/2018] [Accepted: 04/12/2018] [Indexed: 10/17/2022]
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Evidence of zoonotic leprosy in Pará, Brazilian Amazon, and risks associated with human contact or consumption of armadillos. PLoS Negl Trop Dis 2018; 12:e0006532. [PMID: 29953440 PMCID: PMC6023134 DOI: 10.1371/journal.pntd.0006532] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/15/2018] [Indexed: 11/19/2022] Open
Abstract
Mycobacterium leprae (M. leprae) is a human pathogen and the causative agent for leprosy, a chronic disease characterized by lesions of the skin and peripheral nerve damage. Zoonotic transmission of M. leprae to humans by nine-banded armadillos (Dasypus novemcinctus) has been shown to occur in the southern United States, mainly in Texas, Louisiana, and Florida. Nine-banded armadillos are also common in South America, and residents living in some areas in Brazil hunt and kill armadillos as a dietary source of protein. This study examines the extent of M. leprae infection in wild armadillos and whether these New World mammals may be a natural reservoir for leprosy transmission in Brazil, similar to the situation in the southern states of the U.S. The presence of the M. leprae-specific repetitive sequence RLEP was detected by PCR amplification in purified DNA extracted from armadillo spleen and liver tissue samples. A positive RLEP signal was confirmed in 62% of the armadillos (10/16), indicating high rates of infection with M. leprae. Immunohistochemistry of sections of infected armadillo spleens revealed mycobacterial DNA and cell wall constituents in situ detected by SYBR Gold and auramine/rhodamine staining techniques, respectively. The M. leprae-specific antigen, phenolic glycolipid I (PGL-I) was detected in spleen sections using a rabbit polyclonal antibody specific for PGL-I. Anti-PGL-I titers were assessed by ELISA in sera from 146 inhabitants of Belterra, a hyperendemic city located in western Pará state in Brazil. A positive anti-PGL-I titer is a known biomarker for M. leprae infection in both humans and armadillos. Individuals who consumed armadillo meat most frequently (more than once per month) showed a significantly higher anti-PGL-I titer than those who did not eat or ate less frequently than once per month. Armadillos infected with M. leprae represent a potential environmental reservoir. Consequently, people who hunt, kill, or process or eat armadillo meat are at a higher risk for infection with M. leprae from these animals.
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Geluk A. Correlates of immune exacerbations in leprosy. Semin Immunol 2018; 39:111-118. [PMID: 29950273 DOI: 10.1016/j.smim.2018.06.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 06/18/2018] [Accepted: 06/20/2018] [Indexed: 01/13/2023]
Abstract
Leprosy is still a considerable health threat in pockets of several low and middle income countries worldwide where intense transmission is witnessed, and often results in irreversible disabilities and deformities due to delayed- or misdiagnosis. Early detection of leprosy represents a substantial hurdle in present-day leprosy health care. The dearth of timely diagnosis has, however, particularly severe consequences in the case of inflammatory episodes, designated leprosy reactions, which represent the major cause of leprosy-associated irreversible neuropathy. There is currently no accurate, routine diagnostic test to reliably detect leprosy reactions, or to predict which patients will develop these immunological exacerbations. Identification of host biomarkers for leprosy reactions, particularly if correlating with early onset prior to development of clinical symptoms, will allow timely interventions that contribute to decreased morbidity. Development of a point-of-care (POC) test based on such correlates would be a definite game changer in leprosy health care. In this review, proteomic-, transcriptomic and metabolomic research strategies aiming at identification of host biomarker-based correlates of leprosy reactions are discussed, next to external factors associated with occurrence of these episodes. The vast diversity in research strategies combined with the variability in patient- and control cohorts argues for harmonisation of biomarker discovery studies with geographically overarching study sites. This will improve identification of specific correlates associated with risk of these damaging inflammatory episodes in leprosy and subsequent application to rapid field tests.
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Affiliation(s)
- Annemieke Geluk
- Dept. of Infectious Diseases, LUMC, PO Box 9600, 2300 RC Leiden, The Netherlands.
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Wang D, Fan Y, Malhi M, Bi R, Wu Y, Xu M, Yu XF, Long H, Li YY, Zhang DF, Yao YG. Missense Variants in HIF1A and LACC1 Contribute to Leprosy Risk in Han Chinese. Am J Hum Genet 2018; 102:794-805. [PMID: 29706348 DOI: 10.1016/j.ajhg.2018.03.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 03/01/2018] [Indexed: 12/20/2022] Open
Abstract
Genome-wide association studies (GWASs) and genome-wide linkage studies (GWLSs) have identified numerous risk genes affecting the susceptibility to leprosy. However, most of the reported GWAS hits are noncoding variants and account for only part of the estimated heritability for this disease. In order to identify additional risk genes and map the potentially functional variants within the GWAS loci, we performed a three-stage study combining whole-exome sequencing (WES; discovery stage), targeted next-generation sequencing (NGS; screening stage), and refined validation of risk missense variants in 1,433 individuals with leprosy and 1,625 healthy control individuals from Yunnan Province, Southwest China. We identified and validated a rare damaging variant, rs142179458 (c.1045G>A [p.Asp349Asn]) in HIF1A, as contributing to leprosy risk (p = 4.95 × 10-9, odds ratio [OR] = 2.266). We were able to show that affected individuals harboring the risk allele presented with multibacillary leprosy at an earlier age (p = 0.025). We also confirmed the association between missense variant rs3764147 (c.760A>G [p.Ile254Val]) in the GWAS hit LACC1 (formerly C13orf31) and leprosy (p = 6.11 × 10-18, OR = 1.605). By using the population attributable fraction, we have shown that HIF1A and LACC1 are the major genes with missense variants contributing to leprosy risk in our study groups. Consistently, mRNA expression levels of both HIF1A and LACC1 were upregulated in the skin lesions of individuals with leprosy and in Mycobacterium leprae-stimulated cells, indicating an active role of HIF1A and LACC1 in leprosy pathogenesis.
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Zhang H, Wang Z, Fu X, Sun Y, Mi Z, Yu G, Sun L, Wang N, Wang C, Zhao Q, Pan Q, Yue Z, Liu H, Zhang F. A pathway-based association analysis identified FMNL1-MAP3K14 as susceptibility genes for leprosy. Exp Dermatol 2018; 27:245-250. [PMID: 29283461 DOI: 10.1111/exd.13490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 02/04/2023]
Abstract
The nuclear transcription factor-κB (NF-κB) plays a pivotal role in controlling both innate and adaptive immunity and regulates the expressions of many immunological mediators. Abundant evidences have showed the importance of NF-κB pathway in the host immune responses against Mycobacterium leprae in the development of leprosy. However, no particular association study between leprosy and NF-κB pathway-related gene polymorphisms was reported. Here, we performed a large-scale and two-stage candidate association study to investigate the association between 94 NF-κB pathway-related genes and leprosy. Our results showed that rs58744688 was significantly associated with leprosy (P = 7.57 × 10-7 , OR = 1.12) by combining the previous genomewide association data sets and four independent validation sample series, consisting of a total of 4631 leprosy cases and 6413 healthy controls. This founding implicated that MAP3K14 and FMNL1 were susceptibility genes for leprosy, which suggested the involvement of macrophage targeting and NF-κB pathway in the development of leprosy.
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Affiliation(s)
- Huimin Zhang
- Binzhou Medical University, Yantai, Shandong, China
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Zhenzhen Wang
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Xi'an Fu
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- School of Medicine, Shandong University, Jinan, Shandong, China
| | - Yonghu Sun
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Zihao Mi
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Gongqi Yu
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- School of Medicine and Life Science, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Lele Sun
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Na Wang
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- School of Medicine, Shandong University, Jinan, Shandong, China
| | - Chuan Wang
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Qing Zhao
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- School of Medicine, Shandong University, Jinan, Shandong, China
| | - Qing Pan
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
| | - Zhenhua Yue
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- School of Medicine, Shandong University, Jinan, Shandong, China
| | - Hong Liu
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, Shandong, China
| | - Furen Zhang
- Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Key Laboratory for Dermatovenereology, Jinan, Shandong, China
- School of Medicine, Shandong University, Jinan, Shandong, China
- School of Medicine and Life Science, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Shandong Provincial Hospital for Skin Diseases, Shandong University, Jinan, Shandong, China
- National Clinical Key Project of Dermatology and Venereology, Jinan, Shandong, China
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Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies. Pain Rep 2018; 3:e638. [PMID: 29756085 PMCID: PMC5902246 DOI: 10.1097/pr9.0000000000000638] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/19/2017] [Accepted: 12/25/2017] [Indexed: 01/16/2023] Open
Abstract
Supplemental Digital Content is Available in the Text. Neuropathic pain in leprosy may respond to drugs usually used to control pain of neuropathic profile and amitriptiline may constitute a candidate drug for future formal clinical trials. Introduction: Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in “pharmacologically cured” patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient's quality of life, daily activities, and mood. Objectives: The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy. Methods: Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on drugs prescribed for neuropathic pain and their respective pain relief. Results: The pain characteristics based on NPSI did not significantly differ between leprosy and nonleprosy neuropathic pain patients in visit 1 after correction for multiple analyses, and cluster analyses confirmed these findings (ie, no discrimination between leprosy and nonleprosy groups; Pearson χ2 = 0.072, P = 0.788). The assessment of pain relief response and the drugs taken by each patient, linear regression analysis showed that amitriptyline, when effective, had the highest percentage of analgesic relief. Conclusions: Neuropathic pain in leprosy is as heterogeneous as neuropathic pain of other etiologies, further supporting the concept that neuropathic pain is a transetiological entity. Neuropathic pain in leprosy may respond to drugs usually used to control pain of neuropathic profile in general, and amitriptiline may constitute a potential candidate drug for future formal clinical trials aimed at controlling neuropathic pain in leprosy.
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Wang D, Zhang DF, Li GD, Bi R, Fan Y, Wu Y, Yu XF, Long H, Li YY, Yao YG. A pleiotropic effect of the APOE gene: association of APOE polymorphisms with multibacillary leprosy in Han Chinese from Southwest China. Br J Dermatol 2018; 178:931-939. [PMID: 28977675 DOI: 10.1111/bjd.16020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Patients with leprosy have a very low risk of Alzheimer disease (AD) and β-amyloid (Aβ) deposition is significantly lower in the brain tissue of elderly patients with leprosy compared with age-matched controls. Apolipoprotein E (ApoE) plays a critical role in lipid metabolic pathways and in the brain, facilitating the proteolytic clearance of Aβ. We hypothesized that APOE confers risk of leprosy as lipid metabolism is involved in Mycobacterium leprae infection. OBJECTIVES To investigate the potential genetic associations between APOE and leprosy in two independent Chinese case-control cohorts from the Yuxi and Wenshan prefectures, Yunnan Province of Southwest China. METHODS Five APOE single-nucleotide polymorphisms (SNPs) were analysed in 1110 individuals (527 patients and 583 controls) from the Yuxi prefecture using a SNaPshot assay. Genetic variations in the entire APOE exons were screened in 1788 individuals (798 patients and 990 controls) from the Wenshan prefecture using next-generation sequencing technology. RESULTS The AD-associated SNPs rs405509 and rs439401 increased the risk of leprosy per se and multibacillary leprosy (P < 0·005), but the APOE-ε4 allele did not. The SNPs rs405509 and rs439401 were cis expression quantitative trait loci (eQTL) for APOE expression in human skin. Differential APOE mRNA expression was observed in skin lesions of patients with type I reaction leprosy and those with multibacillary leprosy. APOE and related lipid genes are involved in an interaction network with leprosy susceptibility genes. CONCLUSIONS The APOE gene is associated with leprosy, most likely by regulating lipid-metabolism-related genes.
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Affiliation(s)
- D Wang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - D-F Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - G-D Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650201, China
| | - R Bi
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - Y Fan
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - Y Wu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650201, China
| | - X-F Yu
- Wenshan Institute of Dermatology, Wenshan, Yunnan, 663000, China
| | - H Long
- Wenshan Institute of Dermatology, Wenshan, Yunnan, 663000, China
| | - Y-Y Li
- Department of Dermatology, the First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650032, China
| | - Y-G Yao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China.,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650201, China
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Almasi S, Aliparasti MR, Naghili B, Yeganeh K, Rahnama B, Tavanafar F, Hazhir Karzar B, Amini Khiabani S, Naghili A, Babaloo Z. Analysis of CTLA-4+49A/G gene polymorphism in cases with leprosy of Azerbaijan, Northwest Iran. INFECTION GENETICS AND EVOLUTION 2017; 57:121-127. [PMID: 29104093 DOI: 10.1016/j.meegid.2017.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022]
Abstract
Leprosy, which is developed by the obligate intracellular Mycobacterium leprae (ML); has different manifestations, associated with the host immune responses. The protective immune response against ML includes T-cell-mediated immunity. The CTLA-4 has a great impact as a negative regulator of the immune response and maintenance of peripheral tolerance. This study analyzed the relationship between CTLA-4+49A/G gene polymorphism and clinical manifestation of leprosy disease and susceptibility among the Azeri population living Northwest Iran. One hundred and ninety-two leprosy patients and 185 healthy controls participated in the study. CTLA-4+49A/G genotyping was conducted via tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) analysis. The allelic and genotypic frequencies of +49A/G gene polymorphism were similar in controls and patients. However, older ages, older age of onset and over-representation in male were observed in lepromatous leprosy patient carriers of GG genotype. The current study demonstrates that although CTLA-4+49A/G polymorphism was not correlated with a higher genetic risk for leprosy, the presence of a GG genotype was associated with older ages, older age of onset and over-representation in male in Iranian Azeri population.
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Affiliation(s)
- Shohreh Almasi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Reza Aliparasti
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Immunology Unit, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Behrouz Naghili
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Khalil Yeganeh
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Badrossadat Rahnama
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Tavanafar
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bita Hazhir Karzar
- Students' Research Committee, Medical Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Arman Naghili
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Babaloo
- Immunology Unit, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Field-friendly serological tests for determination of M. leprae-specific antibodies. Sci Rep 2017; 7:8868. [PMID: 28827673 PMCID: PMC5566372 DOI: 10.1038/s41598-017-07803-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/29/2017] [Indexed: 11/09/2022] Open
Abstract
Early detection of leprosy is key to reduce the ongoing transmission. Antibodies directed against M. leprae PGL-I represent a useful biomarker for detecting multibacillary (MB) patients. Since efficient leprosy diagnosis requires field-friendly test conditions, we evaluated two rapid lateral flow assays (LFA) for detection of Mycobacterium leprae-specific antibodies: the visual immunogold OnSite Leprosy Ab Rapid test [Gold-LFA] and the quantitative, luminescent up-converting phosphor anti-PGL-I test [UCP-LFA]. Test performance was assessed in independent cohorts originating from three endemic areas. In the Philippine cohort comprising patients with high bacillary indices (BI; average:4,9), 94%(n = 161) of MB patients were identified by UCP-LFA and 78%(n = 133) by Gold-LFA. In the Bangladeshi cohort, including mainly MB patients with low BI (average:1), 41%(n = 14) and 44%(n = 15) were detected by UCP-LFA and Gold-LFA, respectively. In the third cohort of schoolchildren from a leprosy hyperendemic region in Brazil, both tests detected 28%(n = 17) seropositivity. Both rapid tests corresponded well with BI(p < 0.0001), with a fairly higher sensitivity obtained with the UCP-LFA assay. However, due to the spectral character of leprosy, additional, cellular biomarkers are required to detect patients with low BIs. Therefore, the UCP-LFA platform, which allows multiplexing with differential biomarkers, offers more cutting-edge potential for diagnosis across the whole leprosy spectrum.
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David S, Aguiar P, Antunes L, Dias A, Morais A, Sakuntabhai A, Lavinha J. Variants in the non-coding region of the TLR2 gene associated with infectious subphenotypes in pediatric sickle cell anemia. Immunogenetics 2017; 70:37-51. [DOI: 10.1007/s00251-017-1013-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/07/2017] [Indexed: 12/14/2022]
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Avanzi C, Del-Pozo J, Benjak A, Stevenson K, Simpson VR, Busso P, McLuckie J, Loiseau C, Lawton C, Schoening J, Shaw DJ, Piton J, Vera-Cabrera L, Velarde-Felix JS, McDermott F, Gordon SV, Cole ST, Meredith AL. Red squirrels in the British Isles are infected with leprosy bacilli. Science 2017; 354:744-747. [PMID: 27846605 DOI: 10.1126/science.aah3783] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/27/2016] [Indexed: 12/15/2022]
Abstract
Leprosy, caused by infection with Mycobacterium leprae or the recently discovered Mycobacterium lepromatosis, was once endemic in humans in the British Isles. Red squirrels in Great Britain (Sciurus vulgaris) have increasingly been observed with leprosy-like lesions on the head and limbs. Using genomics, histopathology, and serology, we found M. lepromatosis in squirrels from England, Ireland, and Scotland, and M. leprae in squirrels from Brownsea Island, England. Infection was detected in overtly diseased and seemingly healthy animals. Phylogenetic comparisons of British and Irish M. lepromatosis with two Mexican strains from humans show that they diverged from a common ancestor around 27,000 years ago, whereas the M. leprae strain is closest to one that circulated in Medieval England. Red squirrels are thus a reservoir for leprosy in the British Isles.
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Affiliation(s)
- Charlotte Avanzi
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Jorge Del-Pozo
- Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, Scotland, UK
| | - Andrej Benjak
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Karen Stevenson
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, Scotland, UK
| | - Victor R Simpson
- Wildlife Veterinary Investigation Centre, Chacewater, Cornwall, UK
| | - Philippe Busso
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Joyce McLuckie
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, Scotland, UK
| | - Chloé Loiseau
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Colin Lawton
- School of Natural Sciences, Ryan Institute, National University of Ireland, Galway, Ireland
| | - Janne Schoening
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Darren J Shaw
- Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, Scotland, UK
| | - Jérémie Piton
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland
| | - Lucio Vera-Cabrera
- Laboratorio Interdisciplinario de Investigación Dermatológica, Servicio de Dermatología, Hospital Universitario, Monterrey, N.L., Mexico
| | - Jesùs S Velarde-Felix
- Laboratorio Interdisciplinario de Investigación Dermatológica, Servicio de Dermatología, Hospital Universitario, Monterrey, N.L., Mexico
| | - Fergal McDermott
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Stephen V Gordon
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland.,UCD School of Medicine, University College Dublin, Belfield, Dublin, Ireland.,UCD School of Biomolecular and Biomedical Science, University College Dublin, Belfield, Dublin, Ireland.,UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin, Ireland
| | - Stewart T Cole
- Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland.
| | - Anna L Meredith
- Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, Scotland, UK.
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30
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Rodrigues RWDP, Ribeiro AB, Berber GDCM, Sheng L, Damazo AS. Analysis of clinical data and T helper 1/T helper 2 responses in patients with different clinical forms of leprosy. Rev Soc Bras Med Trop 2017; 50:208-215. [PMID: 28562757 DOI: 10.1590/0037-8682-0426-2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/24/2017] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION: Currently, there are no laboratory tests or sensitive and specific molecular markers for the early diagnosis of leprosy. The aim of this study was to analyze the clinical characteristics of patients with leprosy and investigate their immunological profile, comparing this with the type of lesion and the presence or absence of a Bacillus Calmette-Guérin (BCG) vaccination scar. METHODS: Statistical analyzes were performed by employing comparative tests (Pearson´s chi-square) to evaluate the variables in different clinical forms, considering significance at the 5% level. RESULTS: The study identified a predominance of lepromatous leprosy (26.9%) in patients aged between 34-53 years. Caucasians predominantly had borderline tuberculoid (BT) clinical forms (42%); a predominance of males with borderline lepromatous (19%) and lepromatous leprosy (26.9%) forms was observed; and the presence of BCG vaccination scars (27.5%) and lower limb nerves were more affected (38%) predominantly in the BT clinical form. Significant differences were identified, which included hypochromic lesions predominantly in the BT clinical form (24%); diffuse-type lesions predominantly in the tuberculoid (TT) clinical form (28%); ill-defined lesion border dominance in lepromatous leprosy (LL) clinical forms (30%); an irregular lesion limit predominantly in LL clinical forms (32%); and a predominant Th1 immune response in the BT clinical form (41.7%). CONCLUSIONS: The evaluation of the immunological profile in leprosy patients may contribute to the more detailed diagnosis and possibly better characterization of the prognosis for these individuals.
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Affiliation(s)
- Ricardo Wilson de Pinho Rodrigues
- Instituto de Ciências da Saúde, Universidade Federal do Mato Grosso, Sinop, MT, Brasil.,Curso de Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Mato Grosso, Cuiabá, MT, Brasil
| | - Afonso Bezerra Ribeiro
- Curso de Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Mato Grosso, Cuiabá, MT, Brasil
| | | | - LeeYun Sheng
- Instituto de Ciências Naturais e Humanas, Universidade Federal do Mato Grosso, Sinop, MT, Brasil
| | - Amilcar Sabino Damazo
- Curso de Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Mato Grosso, Cuiabá, MT, Brasil.,Departamento de Ciências Básicas em Saúde, Faculdade de Medicina, Universidade Federal do Mato Grosso, Cuiabá, MT, Brasil
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31
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Abstract
MJ is a janitor working in an office building for the past 5 years. He sustained a third-degree burn with a secondary infection and was sent to the county hospital. He was diagnosed with leprosy. The employees in the office building were concerned with the risk of transmission. This article reviews leprosy, and implications for occupational health nurses are discussed.
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Roffey S, Tucker K, Filipek-Ogden K, Montgomery J, Cameron J, O’Connell T, Evans J, Marter P, Taylor GM. Investigation of a Medieval Pilgrim Burial Excavated from the Leprosarium of St Mary Magdalen Winchester, UK. PLoS Negl Trop Dis 2017; 11:e0005186. [PMID: 28125649 PMCID: PMC5268360 DOI: 10.1371/journal.pntd.0005186] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/15/2016] [Indexed: 01/10/2023] Open
Abstract
We have examined the remains of a Pilgrim burial from St Mary Magdalen, Winchester. The individual was a young adult male, aged around 18–25 years at the time of death. Radiocarbon dating showed the remains dated to the late 11th–early 12th centuries, a time when pilgrimages were at their height in Europe. Several lines of evidence in connection with the burial suggested this was an individual of some means and prestige. Although buried within the leprosarium cemetery, the skeleton showed only minimal skeletal evidence for leprosy, which was confined to the bones of the feet and legs. Nonetheless, molecular testing of several skeletal elements, including uninvolved bones all showed robust evidence of DNA from Mycobacterium leprae, consistent with the lepromatous or multibacillary form of the disease. We infer that in life, this individual almost certainly suffered with multiple soft tissue lesions. Genotyping of the M.leprae strain showed this belonged to the 2F lineage, today associated with cases from South-Central and Western Asia. During osteological examination it was noted that the cranium and facial features displayed atypical morphology for northern European populations. Subsequently, geochemical isotopic analyses carried out on tooth enamel indicated that this individual was indeed not local to the Winchester region, although it was not possible to be more specific about their geographic origin. This multidisciplinary research article, involving biomolecular analysis, osteology, strontium and oxygen isotopic analyses and archaeology, examines the remains of a Pilgrim burial excavated from the medieval leprosy hospital of St Mary Magdalen, Winchester, UK. Radiocarbon dating showed the remains dated to the late 11th–early 12th centuries, a time when pilgrimages were at their height in Europe. The leprosarium at Winchester is one of the earliest excavated examples from Western Europe and has been the subject of a series of recent academic papers. The site is remarkable for the high number of burials displaying skeletal lesions characteristic of leprosy (86%) and the state of preservation of biomolecular markers of the disease, including mycolipids and DNA. Genotyping of the M.leprae strain showed this belonged to the 2F lineage, today associated with cases from South-Central and Western Asia. Several aspects of the burial and dietary isotope analysis indicated this was an individual of some prestige and means; an unusual cranial morphology pointed to possible origin outside of the British Isles. Strontium and oxygen isotopic analyses confirmed he was not local to the Winchester area but were not able to pinpoint his precise origins. Overall these findings confirm the benefits of a multidisciplinary approach which allows investigation of the wider relationship between leprosy, medieval pilgrimage and M.leprae transmission.
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Affiliation(s)
- Simon Roffey
- Department of Archaeology, University of Winchester, Winchester, United Kingdom
- * E-mail:
| | - Katie Tucker
- Department of Archaeology, University of Winchester, Winchester, United Kingdom
| | | | - Janet Montgomery
- Department of Archaeology, Durham University, Durham United Kingdom
| | - Jamie Cameron
- Research Laboratory for Archaeology and the History of Art, University of Oxford, Dyson Perrins Building, Oxford, United Kingdom
| | - Tamsin O’Connell
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge, United Kingdom
| | - Jane Evans
- NERC Isotope Geosciences Laboratory, Keyworth, Notts, United Kingdom
| | - Phil Marter
- Department of Archaeology, University of Winchester, Winchester, United Kingdom
| | - G. Michael Taylor
- Department of Microbial and Cellular Sciences, Faculty of Health and Medical Sciences, AX Building, University of Surrey, Guildford, Surrey, United Kingdom
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Aguilar-Medina M, Escamilla-Tilch M, Frías-Castro LO, Romero-Quintana G, Estrada-García I, Estrada-Parra S, Granados J, Arambula Meraz E, Sánchez-Schmitz G, Khader SA, Rangel-Moreno J, Ramos-Payán R. HLA Alleles are Genetic Markers for Susceptibility and Resistance towards Leprosy in a Mexican Mestizo Population. Ann Hum Genet 2016; 81:35-40. [PMID: 28025823 DOI: 10.1111/ahg.12183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 12/04/2016] [Indexed: 01/27/2023]
Abstract
Despite the use of multidrug therapy, leprosy remains endemic in some countries. The association of several human leucocyte antigen (HLA) alleles and gene polymorphisms with leprosy has been demonstrated in many populations, but the major immune contributors associated to the spectrum of leprosy have not been defined yet. In this study, genotyping of HLA-A, -B, -DR, and -DQ alleles was performed in leprosy patients (n = 113) and control subjects (n = 117) from the region with the highest incidence for the disease in México. The odds of developing leprosy and lepromatous subtype were 2.12- and 2.74-fold higher in carriers of HLA-A*28, and 2.48- and 4.14-fold higher for leprosy and dimorphic subtype in carriers of DQB1*06. Interestingly, DQB1*07 was overrepresented in healthy individuals, compared to patients with leprosy (OR = 0.08) and the lepromatous subtype (OR = 0.06). These results suggest that HLA-A*28 is a marker for predisposition to leprosy and the lepromatous subtype and DQB1*06 to leprosy and the dimorphic subtype, while DQB1*07 might be a resistance marker in this Mestizo population.
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Affiliation(s)
- Maribel Aguilar-Medina
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
| | - Monica Escamilla-Tilch
- Division of Immunogenetics, National Institute of Medical Sciences and Nutrition, CDMX, Mexico
| | | | - Geovanni Romero-Quintana
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
| | - Iris Estrada-García
- Department of Immunology, National School of Biological Science, National Polytechnic Institute, CDMX, Mexico
| | - Sergio Estrada-Parra
- Department of Immunology, National School of Biological Science, National Polytechnic Institute, CDMX, Mexico
| | - Julio Granados
- Division of Immunogenetics, National Institute of Medical Sciences and Nutrition, CDMX, Mexico
| | - Eliakym Arambula Meraz
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
| | - Guzman Sánchez-Schmitz
- Division of Infectious Diseases, Boston Children's Hospital and Harvard Medical School, Harvard University, Boston, MA, USA
| | | | - Javier Rangel-Moreno
- Division of Allergy, Immunology and Rheumatology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA
| | - Rosalío Ramos-Payán
- Faculty of Biological and Chemical Sciences, Autonomous University of Sinaloa, Culiacán, Sinaloa, Mexico
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34
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Common variants in the PARL and PINK1 genes increase the risk to leprosy in Han Chinese from South China. Sci Rep 2016; 6:37086. [PMID: 27876828 PMCID: PMC5120299 DOI: 10.1038/srep37086] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/24/2016] [Indexed: 01/04/2023] Open
Abstract
Leprosy is a chronic infectious and neurological disease caused by Mycobacterium leprae, an unculturable pathogen with massive genomic decay and dependence on host metabolism. We hypothesized that mitochondrial genes PARL and PINK1 would confer risk to leprosy. Thirteen tag SNPs of PARL and PINK1 were analyzed in 3620 individuals with or without leprosy from China. We also sequenced the entire exons of PARL, PINK1 and PARK2 in 80 patients with a family history of leprosy by using the next generation sequencing technology (NGS). We found that PARL SNP rs12631031 conferred a risk to leprosy (Padjusted = 0.019) and multibacillary leprosy (MB, Padjusted = 0.020) at the allelic level. rs12631031 and rs7653061 in PARL were associated with leprosy and MB (dominant model, Padjusted < 0.05) at the genotypic level. PINK1 SNP rs4704 was associated with leprosy at the genotypic level (Padjusted = 0.004). We confirmed that common variants in PARL and PINK1 were associated with leprosy in patients underwent NGS. Furthermore, PARL and PINK1 could physically interact with each other and were involved in the highly connected network formed by reported leprosy susceptibility genes. Together, our results showed that PARL and PINK1 genetic variants are associated with leprosy.
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35
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Genetic variants of the MAVS, MITA and MFN2 genes are not associated with leprosy in Han Chinese from Southwest China. INFECTION GENETICS AND EVOLUTION 2016; 45:105-110. [DOI: 10.1016/j.meegid.2016.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 08/19/2016] [Accepted: 08/19/2016] [Indexed: 01/04/2023]
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36
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Sharma R, Singh P, Loughry WJ, Lockhart JM, Inman WB, Duthie MS, Pena MT, Marcos LA, Scollard DM, Cole ST, Truman RW. Zoonotic Leprosy in the Southeastern United States. Emerg Infect Dis 2016; 21:2127-34. [PMID: 26583204 PMCID: PMC4672434 DOI: 10.3201/eid2112.150501] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The geographic range and complexity of this disease are increasing. Nine-banded armadillos (Dasypus novemcinctus) are naturally infected
with Mycobacterium leprae and have been implicated in zoonotic
transmission of leprosy. Early studies found this disease mainly in Texas and
Louisiana, but armadillos in the southeastern United States appeared to be free of
infection. We screened 645 armadillos from 8 locations in the southeastern United
States not known to harbor enzootic leprosy for M. leprae DNA and
antibodies. We found M. leprae–infected armadillos at each
location, and 106 (16.4%) animals had serologic/PCR evidence of infection. Using
single-nucleotide polymorphism variable number tandem repeat genotyping/genome
sequencing, we detected M. leprae genotype 3I-2-v1 among 35
armadillos. Seven armadillos harbored a newly identified genotype (3I-2-v15). In
comparison, 52 human patients from the same region were infected with 31 M.
leprae types. However, 42.3% (22/52) of patients were infected with 1 of
the 2 M. leprae genotype strains associated with armadillos. The
geographic range and complexity of zoonotic leprosy is expanding.
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37
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Pitman Harris A, Matusitz J. The Exile of Hansen's Disease Patients to Moloka'i: A Diffusion of Innovations Perspective. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:299-308. [PMID: 27105179 DOI: 10.1080/19371918.2015.1137514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article analyzes the exile of patients with Hansen's disease (leprosy) to Moloka'i (Hawaii) by applying the diffusion of innovations (DoI) theory. Developed by Rogers, DoI posits that an innovation (i.e., idea, movement, or trend) is initiated within a culture. Then, it is diffused via particular channels across diverse cultures. Instead of evolving independently, innovations diffuse from one culture to another through various forms of contact and communication. In the context of this analysis, the objective is to examine how the diffusion of certain ideas, namely, abolishing the stigma associated with leprosy, could have improved the lives of Hawaiians. An important premise of this article is that the Hawaiian government barely applied the tenets of DoI, which is the reason why many people lost their lives. So, this article seeks to explore what could have been done to improve their situation and what pitfalls should be avoided in the future.
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Affiliation(s)
- Adrea Pitman Harris
- a University of Central Florida, UCF-Sanford/Lake Mary , Sanford , Florida , USA
| | - Jonathan Matusitz
- a University of Central Florida, UCF-Sanford/Lake Mary , Sanford , Florida , USA
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38
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Gaschignard J, Grant AV, Thuc NV, Orlova M, Cobat A, Huong NT, Ba NN, Thai VH, Abel L, Schurr E, Alcaïs A. Pauci- and Multibacillary Leprosy: Two Distinct, Genetically Neglected Diseases. PLoS Negl Trop Dis 2016; 10:e0004345. [PMID: 27219008 PMCID: PMC4878860 DOI: 10.1371/journal.pntd.0004345] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
After sustained exposure to Mycobacterium leprae, only a subset of exposed individuals develops clinical leprosy. Moreover, leprosy patients show a wide spectrum of clinical manifestations that extend from the paucibacillary (PB) to the multibacillary (MB) form of the disease. This "polarization" of leprosy has long been a major focus of investigation for immunologists because of the different immune response in these two forms. But while leprosy per se has been shown to be under tight human genetic control, few epidemiological or genetic studies have focused on leprosy subtypes. Using PubMed, we collected available data in English on the epidemiology of leprosy polarization and the possible role of human genetics in its pathophysiology until September 2015. At the genetic level, we assembled a list of 28 genes from the literature that are associated with leprosy subtypes or implicated in the polarization process. Our bibliographical search revealed that improved study designs are needed to identify genes associated with leprosy polarization. Future investigations should not be restricted to a subanalysis of leprosy per se studies but should instead contrast MB to PB individuals. We show the latter approach to be the most powerful design for the identification of genetic polarization determinants. Finally, we bring to light the important resource represented by the nine-banded armadillo model, a unique animal model for leprosy.
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Affiliation(s)
- Jean Gaschignard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, INSERM, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
| | - Audrey Virginia Grant
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, INSERM, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
- Unité de Génétique fonctionnelle des maladies infectieuses, Institut Pasteur, Paris, France, EU
| | | | - Marianna Orlova
- Program in Infectious Diseases and Immunity in Global Health, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Aurélie Cobat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, INSERM, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
| | | | - Nguyen Ngoc Ba
- Hospital for Dermato-Venerology, Ho Chi Minh City, Vietnam
| | - Vu Hong Thai
- Hospital for Dermato-Venerology, Ho Chi Minh City, Vietnam
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, INSERM, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
| | - Erwin Schurr
- Program in Infectious Diseases and Immunity in Global Health, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- The McGill International TB Centre, Departments of Human Genetics and Medicine, McGill University, Montreal, Quebec, Canada
| | - Alexandre Alcaïs
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, INSERM, Paris, France, EU
- Paris Descartes University, Imagine Institute, Paris, France, EU
- URC, CIC, Necker and Cochin Hospitals, Paris, France, EU
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Exploratory urinary metabolomics of type 1 leprosy reactions. Int J Infect Dis 2016; 45:46-52. [PMID: 26923082 DOI: 10.1016/j.ijid.2016.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 02/12/2016] [Accepted: 02/16/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Leprosy is an infectious disease caused by Mycobacterium leprae that affects the skin and nerves. Although curable with multidrug therapy, leprosy is complicated by acute inflammatory episodes called reactions, which are the major causes of irreversible neuropathy in leprosy that occur before, during, and even after treatment. Early diagnosis and prompt treatment of reactions reduces the risk of permanent disability. METHODS This exploratory study investigated whether urinary metabolic profiles could be identified that correlate with early signs of reversal reactions (RR). A prospective cohort of leprosy patients with and without reactions and endemic controls was recruited in Nepal. Urine-derived metabolic profiles were measured longitudinally. Thus, a conventional area of biomarker identification for leprosy was extended to non-invasive urine testing. RESULTS It was found that the urinary metabolome could be used to discriminate endemic controls from untreated patients with mycobacterial disease. Moreover, metabolic signatures in the urine of patients developing RR were clearly different before RR onset compared to those at RR diagnosis. CONCLUSIONS This study indicates that urinary metabolic profiles are promising host biomarkers for the detection of intra-individual changes during acute inflammation in leprosy and could contribute to early treatment and prevention of tissue damage.
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Oliveira JM, Rêgo JL, de Lima Santana N, Braz M, Jamieson SE, Vieira TS, Magalhães TL, Machado PRL, Blackwell JM, Castellucci LC. The -308 bp TNF gene polymorphism influences tumor necrosis factor expression in leprosy patients in Bahia State, Brazil. INFECTION GENETICS AND EVOLUTION 2016; 39:147-154. [PMID: 26829382 DOI: 10.1016/j.meegid.2016.01.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 02/04/2023]
Abstract
Leprosy or Hansen's disease is a debilitating chronic granulomatous disease caused by Mycobacterium leprae, with high incidence and prevalence in Brazil. The -308 bp G/A single nucleotide polymorphism (SNP rs1800629) in the tumor necrosis factor (TNF) gene promoter is a proposed risk factor for leprosy. In Brazil, Northern India, Egypt and Nepal, the common G allele was associated with leprosy. In Eastern India, Thailand and Malawi the minor A allele was the risk factor. Allele A was previously associated with high TNF. We genotyped rs1800629 in 326 leprosy cases from Bahia State, Brazil, including 72 paucibacillary (PB) and 47 multibacillary (MB) without reactions, and 69 reversal reaction (RR) and 78 erythema nodosum leprosum (ENL) with reactions. Logistic regression was used to compare patient groups with 331 healthy controls. Relative TNF mRNA was determined in peripheral blood leukocytes by QRTPCR, and serum TNF levels measured by ELISA. We found that TNF mRNA expression was higher (P=0.03) in leprosy patients compared to endemic controls, but did not differ significantly between clinical subgroups. Carriage of the minor A allele was associated (P=0.003) with low TNF mRNA across leprosy patients. Nevertheless, we found no evidence for either allele at this SNP as a risk factor for leprosy per se (OR=1.12, 95% CI 0.79-1.60, P=0.52), PB (OR=0.99, 95% CI 0.54-1.81, P=0.97), MB (OR=0.86, 95% CI 0.40-1.83, P=0.70), RR (OR=1.37, 95% CI 0.79-2.38, P=0.27) or ENL (OR=0.76, 95% CI 0.40-1.45, P=0.42) when compared to endemic controls. Further studies are required to determine whether the influence of the minor A allele on TNF mRNA levels determines response to treatment, particularly in the context of ENL reaction treatment with anti-TNF therapies and RR reactions where treatment with prednisolone is known to reduce TNF levels. Our findings contribute to understanding TNF as an important determinant of leprosy immunopathology in Brazil.
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Affiliation(s)
- Joyce Moura Oliveira
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil; Program of Post-graduation in Health Sciences, Federal University of Bahia, Salvador, Brazil.
| | - Jamile Leão Rêgo
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil; Program of Post-graduation in Health Sciences, Federal University of Bahia, Salvador, Brazil.
| | - Nadja de Lima Santana
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil; Program of Post-graduation in Health Sciences, Federal University of Bahia, Salvador, Brazil.
| | - Marcos Braz
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil; Program of Post-graduation in Health Sciences, Federal University of Bahia, Salvador, Brazil.
| | - Sarra E Jamieson
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, Australia.
| | - Thaillamar Silva Vieira
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil.
| | - Thaís Lamêgo Magalhães
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil.
| | - Paulo Roberto Lima Machado
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil; Program of Post-graduation in Health Sciences, Federal University of Bahia, Salvador, Brazil.
| | - Jenefer M Blackwell
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, Australia.
| | - Léa C Castellucci
- National Institute of Science and Technology in Tropical Diseases, Brazil and Federal University of Bahia, Salvador, Brazil; Program of Post-graduation in Health Sciences, Federal University of Bahia, Salvador, Brazil.
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41
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The GATA3 gene is involved in leprosy susceptibility in Brazilian patients. INFECTION GENETICS AND EVOLUTION 2016; 39:194-200. [PMID: 26807920 DOI: 10.1016/j.meegid.2016.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/23/2015] [Accepted: 01/21/2016] [Indexed: 11/21/2022]
Abstract
Leprosy outcome is a complex trait and the host-pathogen-environment interaction defines the emergence of the disease. Host genetic risk factors have been successfully associated to leprosy. The 10p13 chromosomal region was linked to leprosy in familial studies and GATA3 gene is a strong candidate to be part of this association. Here, we tested tag single nucleotide polymorphisms at GATA3 in two case-control samples from Brazil comprising a total of 1633 individuals using stepwise strategy. The A allele of rs10905284 marker was associated with leprosy resistance. Then, a functional analysis was conducted and showed that individuals carrying AA genotype express higher levels of GATA-3 protein in lymphocytes. So, we confirmed that the rs10905284 is a locus associated to leprosy and influences the levels of this transcription factor in the Brazilian population.
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Santesteban Muruzábal R, Larumbe Irurzun A, Tuñón Alvárez T, Yanguas Bayona I. Placas eritematosas hipoestésicas en paciente procedente de Brasil, un nuevo caso de lepra importada. Aten Primaria 2016; 48:63-4. [PMID: 25976559 PMCID: PMC6880096 DOI: 10.1016/j.aprim.2015.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/10/2015] [Indexed: 11/25/2022] Open
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Kubanov AA, Karamova AE, Vorontsova AA, Kalinina PA. Experimental models of leprosy. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-6-17-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Leprosy (Hansen’s disease) is a chronic granulomatous bacterial disease which mainly affects skin and peripheral nervous system. Leprosy is caused by the obligate intercellular pathogen known as Mycobacterium leprae. Creating experimental models of leprosy is associated with serious problems due to biological characteristics of the pathogen. Numerous attempts to develop experimental models on different types of animals resulted in a few reproducible models on mice and nine-banded armadillos. Strains of knockout mice with genetic defects caused by site-directed mutagenesis are used as a basis for different leprosy models. Experimental models of leprosy are used for screening of anti-leprosy drugs, detection of drug resistance, studies on the pathogenesis of leprosy, production and evaluation of viability of M. leprae, developing of anti-leprosy vaccines.
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Shah JA, Berrington WR, Vary JC, Wells RD, Peterson GJ, Kunwar CB, Khadge S, Hagge DA, Hawn TR. Genetic Variation in Toll-Interacting Protein Is Associated With Leprosy Susceptibility and Cutaneous Expression of Interleukin 1 Receptor Antagonist. J Infect Dis 2015; 213:1189-97. [PMID: 26610735 DOI: 10.1093/infdis/jiv570] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/19/2015] [Indexed: 01/03/2023] Open
Abstract
Leprosy is a chronic disease characterized by skin and peripheral nerve pathology and immune responses that fail to control Mycobacterium leprae. Toll-interacting protein (TOLLIP) regulates Toll-like receptor (TLR) and interleukin 1 receptor (IL-1R) signaling against mycobacteria. We analyzed messenger RNA (mRNA) expression of candidate immune genes in skin biopsy specimens from 85 individuals with leprosy. TOLLIP mRNA was highly and specifically correlated with IL-1R antagonist (IL-1Ra). In a case-control gene-association study with 477 cases and 1021 controls in Nepal, TOLLIP single-nucleotide polymorphism rs3793964 TT genotype was associated with increased susceptibility to leprosy (recessive, P = 1.4 × 10(-3)) and with increased skin expression of TOLLIP and IL-1Ra. Stimulation of TOLLIP-deficient monocytes with M. leprae produced significantly less IL-1Ra (P < .001), compared with control. These data suggest that M. leprae upregulates IL-1Ra by a TOLLIP-dependent mechanism. Inhibition of TOLLIP may decrease an individual's susceptibility to leprosy and offer a novel therapeutic target for IL-1-dependent diseases.
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Affiliation(s)
- Javeed A Shah
- University of Washington School of Medicine, Seattle, Washington
| | | | - James C Vary
- University of Washington School of Medicine, Seattle, Washington Puget Sound VA Health Care System, Seattle, Washington
| | - Richard D Wells
- University of Washington School of Medicine, Seattle, Washington
| | | | - Chhatra B Kunwar
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Saraswoti Khadge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Deanna A Hagge
- Mycobacterial Research Laboratories, Anandaban Hospital, Kathmandu, Nepal
| | - Thomas R Hawn
- University of Washington School of Medicine, Seattle, Washington
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David S, Mateus ARA, Duarte EL, Albuquerque J, Portugal C, Sancho L, Lavinha J, Gonçalves G. Determinants of the Sympatric Host-Pathogen Relationship in Tuberculosis. PLoS One 2015; 10:e0140625. [PMID: 26529092 PMCID: PMC4631367 DOI: 10.1371/journal.pone.0140625] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/29/2015] [Indexed: 01/04/2023] Open
Abstract
Major contributions from pathogen genome analysis and host genetics have equated the possibility of Mycobacterium tuberculosis co-evolution with its human host leading to more stable sympatric host–pathogen relationships. However, the attribution to either sympatric or allopatric categories depends on the resolution or grain of genotypic characterization. We explored the influence on the sympatric host-pathogen relationship of clinical (HIV infection and multidrug-resistant tuberculosis [MDRTB]) and demographic (gender and age) factors in regards to the genotypic grain by using spacer oligonucleotide typing (spoligotyping) for classification of M. tuberculosis strains within the Euro-American lineage. We analyzed a total of 547 tuberculosis (TB) cases, from six year consecutive sampling in a setting with high TB-HIV coinfection (32.0%). Of these, 62.0% were caused by major circulating pathogen genotypes. The sympatric relationship was defined according to spoligotype in comparison to the international spoligotype database SpolDB4. While no significant association with Euro-American lineage was observed with any of the factors analyzed, increasing the resolution with spoligotyping evidenced a significant association of MDRTB with sympatric strains, regardless of the HIV status. Furthermore, distribution curves of the prevalence of sympatric and allopatric TB in relation to patients’ age showed an accentuation of the relevance of the age of onset in the allopatric relationship, as reflected in the trimodal distribution. On the contrary, sympatric TB was characterized by the tendency towards a typical (standard) distribution curve. Our results suggest that within the Euro-American lineage a greater degree of genotyping fine-tuning is necessary in modeling the biological processes behind the host-pathogen interplay. Furthermore, prevalence distribution of sympatric TB to age was suggestive of host genetic determinisms driven by more common variants.
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Affiliation(s)
- Susana David
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
- * E-mail:
| | - A. R. A. Mateus
- Instituto Gulbenkian de Ciência (IGC), Oeiras, Portugal
- Institute of Biology, Leiden University, Leiden, The Netherlands
| | - Elsa L. Duarte
- Escola de Ciências e Tecnologia/ Instituto de Ciências Agrárias e Ambientais Mediterrânicas (ICAAM), Universidade de Évora, Évora, Portugal
| | - José Albuquerque
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
| | - Clara Portugal
- Serviço de Patologia Clínica, Hospital Fernando Fonseca, Amadora, Portugal
| | - Luísa Sancho
- Serviço de Patologia Clínica, Hospital Fernando Fonseca, Amadora, Portugal
| | - João Lavinha
- Departamento de Genética Humana, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
| | - Guilherme Gonçalves
- Unidade Multidisciplinar de Investigação Biomédica (UMIB), Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
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Sauer MED, Salomão H, Ramos GB, D'Espindula HRS, Rodrigues RSA, Macedo WC, Sindeaux RHM, Mira MT. Genetics of leprosy: Expected-and unexpected-developments and perspectives. Clin Dermatol 2015; 34:96-104. [PMID: 26773629 DOI: 10.1016/j.clindermatol.2015.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A solid body of evidence produced over decades of intense research supports the hypothesis that leprosy phenotypes are largely dependent on the genetic characteristics of the host. The early evidence of a major gene effect controlling susceptibility to leprosy came from studies of familial aggregation, twins, and complex segregation analysis. Later, linkage and association analysis, first applied to the investigation of candidate genes and chromosomal regions and more recently, to genome-wide scans, have revealed several HLA and non-HLA gene variants as risk factors for leprosy phenotypes such as disease per se, its clinical forms, and leprosy reactions. In addition, powerful, hypothesis-free strategies such as genome-wide association studies have led to an exciting, unexpected development: Leprosy susceptibility genes seem to be shared with Crohn's and Parkinson's disease. Today, a major challenge is to find the exact variants causing the biological effect underlying the genetic associations. New technologies, such as Next Generation Sequencing-that allows, for the first time, the cost- and time-effective sequencing of a complete human genome-hold the promise to reveal such variants; thus, strategies can be developed to study the functional impact of these variants in the context of infection, hopefully leading to the development of new targets for leprosy treatment and prevention.
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Affiliation(s)
- Monica E D Sauer
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Heloisa Salomão
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Geovana B Ramos
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Helena R S D'Espindula
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Rafael S A Rodrigues
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Wilian C Macedo
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Renata H M Sindeaux
- School of Health and Biological Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Marcelo T Mira
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil; School of Health and Biological Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.
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Xiang YL, Zhang DF, Wang D, Li YY, Yao YG. Common variants of OPA1 conferring genetic susceptibility to leprosy in Han Chinese from Southwest China. J Dermatol Sci 2015; 80:133-41. [PMID: 26360011 DOI: 10.1016/j.jdermsci.2015.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/26/2015] [Accepted: 09/01/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Leprosy is an ancient chronic infection caused by Mycobacterium leprae. Onset of leprosy was highly affected by host nutritional condition and energy production, (partially) due to genomic loss and parasitic life style of M. leprae. The optic atrophy 1 (OPA1) gene plays an essential role in mitochondria, which function in cellular energy supply and innate immunity. OBJECTIVE To investigate the potential involvement of OPA1 in leprosy. METHODS We analyzed 7 common genetic variants of OPA1 in 1110 Han Chinese subjects with and without leprosy, followed by mRNA expression profiling and protein-protein interaction (PPI) network analysis. RESULTS We observed positive associations between OPA1 variants rs9838374 (Pgenotypic=0.003) and rs414237 (Pgenotypic=0.002) with lepromatous leprosy. expression quantitative trait loci (eQTL) analysis showed that the leprosy-related risk allele C of rs414237 is correlated with lower OPA1 mRNA expression level. Indeed, we identified a decrease of OPA1 mRNA expression in both with patients and cellular model of leprosy. In addition, the PPI analysis showed that OPA1 protein was actively involved in the interaction network of M. leprae induced differentially expressed genes. CONCLUSION Our results indicated that OPA1 variants confer risk of leprosy and may affect OPA1 expression, mitochondrial function and antimicrobial pathways.
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Affiliation(s)
- Yang-Lin Xiang
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China; Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - Deng-Feng Zhang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650201, China
| | - Dong Wang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China
| | - Yu-Ye Li
- Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China.
| | - Yong-Gang Yao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan, 650201, China.
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Balamayooran G, Pena M, Sharma R, Truman RW. The armadillo as an animal model and reservoir host for Mycobacterium leprae. Clin Dermatol 2015; 33:108-15. [PMID: 25432816 DOI: 10.1016/j.clindermatol.2014.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Apart from humans, armadillos are the only known natural hosts of Mycobacterium leprae. They are well developed as hosts for in vivo propagation of M leprae and are advancing as models for studying the pathogenesis of leprosy and translational research. Armadillos are immunologically intact. They exhibit the full Ridley-Jopling spectrum of histopathologic responses to M leprae and uniquely manifest extensive neurological involvement that closely recapitulates human leprosy. In addition, free-ranging armadillos in some regions are known to harbor a naturally occurring infection with M leprae, and zoonotic transmission between armadillos and humans has been implicated in a large number of new case presentations. We review the role of the armadillo as a model for leprosy and reservoir for human infection.
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Affiliation(s)
- Gayathriy Balamayooran
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana; Department of Health Human Services, Health Resources and Services Administration, National Hansen's Disease Program, Baton Rouge, Louisiana
| | - Maria Pena
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana; Department of Health Human Services, Health Resources and Services Administration, National Hansen's Disease Program, Baton Rouge, Louisiana
| | - Rahul Sharma
- Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana; Department of Health Human Services, Health Resources and Services Administration, National Hansen's Disease Program, Baton Rouge, Louisiana
| | - Richard W Truman
- Department of Health Human Services, Health Resources and Services Administration, National Hansen's Disease Program, Baton Rouge, Louisiana.
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Sauer MED, Salomão H, Ramos GB, D'Espindula HRS, Rodrigues RSA, Macedo WC, Sindeaux RHM, Mira MT. Genetics of leprosy: expected and unexpected developments and perspectives. Clin Dermatol 2015; 33:99-107. [PMID: 25432815 DOI: 10.1016/j.clindermatol.2014.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A solid body of evidence produced over decades of intense research supports the hypothesis that leprosy phenotypes are largely dependent on the genetic characteristics of the host. The early evidence of a major gene effect controlling susceptibility to leprosy came from studies of familial aggregation, twins, and Complex Segregation Analysis. Later, linkage and association analysis, first applied to the investigation of candidate genes and chromosomal regions and more recently, to genome-wide scans, have revealed several leukocyte antigen complex and nonleukocyte antigen complex gene variants as risk factors for leprosy phenotypes such as disease per se, its clinical forms and leprosy reactions. In addition, powerful, hypothesis-free strategies such as Genome-Wide Association Studies have led to an exciting, unexpected development: Leprosy susceptibility genes seem to be shared with Crohn's and Parkinson's diseases. Today, a major challenge is to find the exact variants causing the biological effect underlying the genetic associations. New technologies, such as Next Generation Sequencing that allows, for the first time, the cost and time-effective sequencing of a complete human genome, hold the promise to reveal such variants. Strategies can be developed to study the functional effect of these variants in the context of infection, hopefully leading to the development of new targets for leprosy treatment and prevention.
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Affiliation(s)
- Monica E D Sauer
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Heloisa Salomão
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Geovana B Ramos
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Helena R S D'Espindula
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Rafael S A Rodrigues
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Wilian C Macedo
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Renata H M Sindeaux
- School of Health and Biological Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Marcelo T Mira
- Group for Advanced Molecular Investigation, Graduate Program in Health Sciences, School of Medicine, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil; School of Health and Biological Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.
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